{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T04:13:42Z","timestamp":1784434422799,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Treatment intensification with androgen receptor signaling inhibitors and\/or chemotherapy is guideline recommended for patients with de novo metastatic hormone\u2010sensitive prostate cancer (mHSPC). However, most patients only receive androgen deprivation therapy monotherapy. The aim was to identify physician\u2010, patient\u2010, and tumor\u2010related factors associated with the receipt of treatment intensification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A population\u2010based cohort study was conducted in Ontario, Canada, which included men \u226566 years newly diagnosed with de novo mHSPC between January 2014 and December 2022. Hierarchical regression modeling was used to examine the association of physician, patient, and tumor characteristics with the receipt of treatment intensification, defined as the initiation of an androgen receptor signaling inhibitor, docetaxel, or both within six months of diagnosis. Darlington\u2019s method was used to assess predictor importance via standardized regression coefficients (SRC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 6099 eligible older men newly diagnosed with de novo mHSPC, 1475 (24.2%) received treatment intensification. In multivariable modeling, patients initiated on androgen deprivation therapy by radiation oncologists were less likely to receive treatment intensification (odds ratio [OR]. 0.48; 95% CI, 0.37\u20130.61;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01; SRC: 19.46;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01) whereas those by medical oncologists were more likely to receive treatment intensification (OR, 1.64; 95% CI, 1.21\u20132.22;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01; SRC: 9.56;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01), each compared to urologists. Older patients were significantly less likely to receive treatment intensification (OR 0.94 per year over age 66; 95% CI, 0.93\u20130.95;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01; SRC: \u201336.21;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patient and physician characteristics significantly influence variation in the use of treatment intensification for de novo mHSPC. These findings inform targeted interventions and policies to enhance the delivery of life\u2010prolonging mHSPC care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70070","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T16:30:18Z","timestamp":1757003418000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Association of patient and physician characteristics with androgen\u2010deprivation\u2010therapy intensification in patients with de novo hormone\u2010sensitive metastatic prostate cancer: A population\u2010based study"],"prefix":"10.1002","volume":"131","author":[{"given":"David\u2010Dan","family":"Nguyen","sequence":"first","affiliation":[{"name":"Division of Urology Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Health Policy Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Satkunasivam","sequence":"additional","affiliation":[{"name":"Department of Urology Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khatereh","family":"Aminoltejari","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology Department of Surgery Princess Margaret Cancer Centre University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Hird","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology Department of Surgery Sunnybrook Health Sciences University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6617-5522","authenticated-orcid":false,"given":"Soumyajit","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Radiation Oncology UH Seidman Cancer Center Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6568-3346","authenticated-orcid":false,"given":"Scott C.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Radiology Radiation Oncology and Medical Physics The Ottawa Hospital Cancer Centre University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5497-3455","authenticated-orcid":false,"given":"Shawn","family":"Malone","sequence":"additional","affiliation":[{"name":"Department of Radiology Radiation Oncology and Medical Physics The Ottawa Hospital Cancer Centre University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Ottawa Hospital Cancer Centre University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1950-2292","authenticated-orcid":false,"given":"Di Maria","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Princess Margaret Cancer Centre University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey T.","family":"Gotto","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"Shayegan","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery St. Joseph\u2019s Healthcare Hamilton McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish S.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology Department of Surgery Princess Margaret Cancer Centre University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney H.","family":"Breau","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery The Ottawa Hospital Research Institute University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly\u2010Khan A.","family":"Lalani","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Juravinski Cancer Centre McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5990-4026","authenticated-orcid":false,"given":"Christopher J. D.","family":"Wallis","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology Department of Surgery Princess Margaret Cancer Centre University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology Department of Surgery Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/CANJCLIN.22.4.232"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/CNCR.32630"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2017.35.15_suppl.lba5003"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903307"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903835"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ANNONC\/MDZ396"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)00367\u20101"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2119115"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003452"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2023.02.015"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EURURO.2024.04.010"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.5489\/CUAJ.8148"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.0050"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/CAM4.4372"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13194951"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002121"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2023.06.010"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2023.05.002"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/JNCICS\/PKAB082"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.5489\/CUAJ.8691"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANETWORKOPEN.2024.48707"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMASURG.2021.0528"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.32.18_SUPPL.LBA2"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/CNCR.27658"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.19.02809"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41391\u2010021\u201000389\u20102"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704174"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1200\/edbk_390396"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894\u2010022\u201000979\u20109"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.23.00723"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.CLGC.2022.06.017"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70070","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.70070","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70070","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:58:37Z","timestamp":1773853117000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.70070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,4]]},"references-count":31,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2025,9,15]]}},"alternative-id":["10.1002\/cncr.70070"],"URL":"https:\/\/doi.org\/10.1002\/cncr.70070","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,4]]},"assertion":[{"value":"2025-05-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70070"}}